Hypogonadism and low bone mineral density in patients on long-term intrathecal opioid delivery therapy

Objectives This study aimed to investigate the hypothalamic-pituitary-gonadal axis in a sample of male patients undertaking intrathecal opioid delivery for the management of chronic non-malignant pain and the presence of osteopaenia and/or osteoporosis in those diagnosed with hypogonadism. Design Ob...

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Bibliographic Details
Published in:BMJ open 2013-05, Vol.3 (6), p.e002856
Main Authors: Duarte, Rui V, Raphael, Jon H, Southall, Jane L, Labib, Mourad H, Whallett, Andrew J, Ashford, Robert L
Format: Article
Language:English
Subjects:
Anaesthesia
Body mass index
Bone density
Drug dosages
Endocrine system
Fractures
Morphine
Narcotics
Osteoporosis
Pain
Patients
Performance evaluation
Testosterone
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Summary:Objectives This study aimed to investigate the hypothalamic-pituitary-gonadal axis in a sample of male patients undertaking intrathecal opioid delivery for the management of chronic non-malignant pain and the presence of osteopaenia and/or osteoporosis in those diagnosed with hypogonadism. Design Observational study using health data routinely collected for non-research purposes. Setting Department of Pain Management, Russells Hall Hospital, Dudley, UK. Patients Twenty consecutive male patients attending follow-up clinics for intrathecal opioid therapy had the gonadal axis evaluated by measuring their serum luteinising hormone, follicle stimulating hormone, total testosterone, sex hormone binding globulin and calculating the free testosterone level. Bone mineral density was measured by DEXA scanning in those patients diagnosed with hypogonadism. Results Based on the calculated free testosterone concentrations, 17 (85%) patients had biochemical hypogonadism with 15 patients (75%) having free testosterone
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2013-002856